Nordic Life Science 1
Ashley Muller REFERENCE MULLER AE, CLAUSEN T, SJØ
GREN P, ODSBU I, SKURTVEIT S. PRESCRIBED OPIOID ANALGESIC USE DEVELOPMENTS IN THREE NORDIC COUNTRIES, 2006–2017. SCAN J PAIN. at the Norwegian Institute of Public Health, is aware of the risks of offering opioids for chronic, noncancer pain. She is American and knows that the United States had more than 200 000 deaths in 1999 – 2016 from prescription opioid-related overdoses. Muller recently published work on opioid prescribing that she did at the Norwegian Centre for Addiction Research, University of Oslo, with collaborators at the University of Copenhagen and Karolinska Institutet. The study confirms that Norway, Denmark, and Sweden do not have an opioid crisis like North America. However, the report contains troubling findings. ”The biggest concern,” Muller says, ”is that oxycodone use increased in all three countries.” Oxycodone is a potent opioid drug linked to the American overdose epidemic. Other research shows increasing deaths in Norway and Sweden related to the drug. Muller and colleagues analyzed publicly available data from Norwegian, Danish, and Swedish prescription drug registries. The data were for 2006–2017 and an impressive 21 million people. For each year, the researchers looked at opioid prevalence, meaning the percent of the population with at least one dispensed opioid drug. The countries had different prescribing patterns. Norway had consistently higher opioid prevalence than Sweden and Denmark, but lower mean doses, except for oxycodone. Sweden had the lowest mean oxycodone doses but wider prescribing, to 3% of the population. Based on these and other findings, Muller says, ”People in public health are worried.” No one is sure of the reason for the prescribing patterns. Oxycodone isn’t advertised in Europe and because of regulations, the cause doesn’t seem to be industry related, Muller says. However, the aging Nordic population means patients may be reporting more pain. Muller and a collaborator are now analyzing data from Norway on people aged 50-80 years. Older people are also receiving increasing amounts of opioids, they find. In general, Muller says, ”Opioids are important for people with acute pain, for example after operations.” One factor in rising opioid use might be that short-term prescriptions turn into long-term use. However, many studies show that opioids are not effective for chronic pain. A bright spot is that Nordic health officials, clinical leaders, and policymakers have an excellent resource – the national prescription drug registries – to help prevent a U.S.type opioid problem. Muller says the drug data she used in her study were easy to use and high quality. Some patients have already developed a use disorder, though, and here’s where the life science industry might help. Muller says: ”There’s room for innovation in ways to help with addiction.” NLS PHOTO AKSEL K.HENRIKEN